• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.125-133
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• 2022

Objectives: No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC. Methods: A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables. Results: Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported. Conclusions: This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.

• 인터넷정보학회논문지
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• 제25권3호
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• pp.55-70
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• 2024

This study aims to compare the differences in the carbon neutral agendas of the two countries based on the differing interest positions of the media in the two countries, as well as to analyze the carbon neutral media coverage in South Korea and China. It also seeks to identify the major topics emphasized in the carbon neutral news agenda setting process in the two countries. A total of 49,227 news articles from South Korea and 105,680 news articles from China, covering the period from the declaration of carbon neutrality in both countries in 2020 to May 9, 2022, were collected. CONCOR and topic modeling analyses were performed on these texts. The results found that South Korean media showed a preference for covering carbon neutrality from the perspective of its inhabitants, whereas Chinese media demonstrated a preference for covering carbon neutrality from the viewpoint of the nation. The discourses on coverages largely focus on areas such as energy strategy, business strategy, industrial growth, and international cooperation, with an obvious lack of discourse on the environment. The findings of this study expect to serve as a primary reference in establishing a news coverage strategy which is environmentally sustainable for the media.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.447-453
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• 2005

The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.

• 지역사회간호학회지
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• 제12권2호
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• pp.513-531
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• 2001

Television news programs are becoming significant source of health information. This study aims at investigating the current state of health coverage of the prime time news program in Korea. Data were collected from KBS 9 0'clock news in the period of thirteen months. from December 1. 1998. to November 1. 1999. The data were analyzed using content analysis method. and the reliability degree was 99.7% according to the Holsti's inter-coder reliability test. The current research classified 489 health related news items into 49 sub-categories and five health categories through content analysis. Some of the basic results of this study are as follows. 1. The frequency according to health category, health maintenance promotion(57.3%) topped followed by disease prevention(23.2%), disease treatment(14.9%), life ethics(4.0%), and growth development(0.6%). 2. According to human developmental age. for the most part(80.1 %) is applicable to the entire range of human developmental age. 3. Health maintennance promotion category take top of health category by the rate of 57.3% and contain 20 sub-categories. 4. News items in the life ethics category, which had six sub-categories. occupied only four percent of the total health related news. News in the growth development category included two sub categories and occupied 0.6% of the total news items. 5. In disease prevention and disease treatment category, infectious disease(33.2%) showed the highest percentage according to the WHO's international disease classification system. Disease prevention occupied 23.2% and contained eleven sub-categories while disease treatment occupied 14.9% and included ten sub-categories. Television news coverage on health showed a wide variety of selection in terms that they are reporting various issues. This study, however, found that some news items were confusing and failing in presenting scientific evidences. It is suggested that the television coverage on health could be beneficial to most of viewers in receiving important health information and guidelines, only if they are utilizing their own sound discretion in consuming those news.

• 보건행정학회지
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• 제31권3호
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• 보건행정학회지
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• 제30권3호
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• Investigative Magnetic Resonance Imaging
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• 제16권2호
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• pp.159-168
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• 2012

흉부대동맥류는 좌측 쇄골하동맥에 가까이 위치해 있어서 흉부대동맥내치료를 시행할 때 좌측 쇄골하동맥의 폐색이 불가피한 경우가 많다. 좌측 쇄골하동맥 폐색의 안전성과 좌측 쇄골하동맥 재생술의 필요성에 대해 논란이 계속되고 있음에도 불구하고, 좌측 쇄골하동맥의 폐색후 뇌혈류역학적인 변화에 대한 기존의 체계적인 연구는 없었다. 저자들은 좌측 쇄골하동맥폐색을 동반한 흉부대동맥내치료의 대상이 되는 2명의 환자에서 치료 전후의 2차원 위상차 대조 자기공명영상을 시행하였다. 좌측 쇄골하동맥의 폐색 후 좌측 쇄골하도주가 발생하였으며, 이로 인한 뇌혈류의 소실을 양측 경동맥과 주된 부행혈류인 오른쪽 추골동맥이 적절하게 보상하였다. 전체 뇌혈류는 감소하지 않았으며 이는 임상적으로 뇌졸증이나 척수마비의 증상이 나타나지 않은 것과 잘 일치하였다. 2차원 위상차 대조 자기공명영상은 좌측 쇄골하동맥 폐색을 동반한 흉부대동맥내치료의 뇌혈류역학적인 평가와 좌측 쇄골하동맥 재생술이 필요한 환자의 선별에 유용할 것으로 사료된다.

• 한국산학기술학회논문지
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• 제20권8호
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• pp.15-22
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• 2019

무선 센서 네트워크는 적은 비용이 들고 낮은 전력으로 구동할 수 있는 센서들이 넓은 범위에 분포한 네트워크이다. 이때 센서들이 주변의 환경을 감시하고 계측한 정보들을 인근의 센서들에게 멀티홉 방식으로 전송하여 최종적으로 모든 데이터들이 베이스 스테이션으로 보내지는 네트워크가 무선 센서 네트워크이다. 여기서 무선 센서 네트워크에 대한 대부분의 연구는 한 위치에 고정되어 주변을 감시하는 정적 센서가 주가 되어왔다. 하지만 정적 센서만으로 이루어진 네트워크와 달리, 드론을 이용하여 네트워크를 구성하게 된다면 네트워크의 전체 커버리지와 에너지 소모를 보다 효율적으로 관리할 수 있다. 본 논문에서는 네트워크를 이루는 드론들에 대한 환경을 모델링하기 위해 전송 전력 모델과 비디오 인코딩 모델을 수식화하여 소개한다. 또한 드론의 효율적인 배치를 위하여 우선순위 지도를 설계하고, 이를 기반으로 커버리지와 에너지를 고려하여 드론들을 배치하는 방식을 보여준다. 다양한 시뮬레이션을 통하여 정적 센서 기반의 네트워크보다 드론 기반의 무선 센서 네트워크에서 더 적은 수의 센서로 커버리지를 증가시키고 소모되는 에너지는 줄여준다는 것을 보여준다. 구체적으로는 정적 센서와 드론의 수가 동일한 가운데 커버리지는 최대 30 퍼센트의 향상이 있고, 에너지 측면에서는 평균 25 퍼센트의 전체 네트워크의 에너지 소모를 줄이면서도 정적 센서 네크워크와 드론 기반 네트워크의 커버리지가 동일하게 유지됨을 보여준다.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.44-48
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• 2001

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wounds. However, in case of complete extremity amputation in eletrical burn patient, the transfer of pedicled flaps from the amputated part is not possible. In such instances, we have designed total arm musculocutaneous free-fillet flaps from the amputated limb to provide wound coverage, when replantation of the amputated part was contraindicated. now we present such a case. This technique allows immediate wound coverage without the morbidity of an additional donor site. The flap provides the ideal combination of large surface area, muscle bulk, and long vascular pedicle. It can be dissected rapidly to minimize ischemic time and could therefore be applicable to traumatic forequarter amputations.